Kerguen Joséphine, Nabet Cathy, Azogui-Lévy Sylvie, Bonnet Anne-Laure, Vital Sibylle, Pierrat Véronique, Kaminski Monique, Dufourg Marie-Noelle, Germa Alice
UMR 1153, Obstetric, Perinatal and Paediatric Life Course Epidemiology, OPPaLE, CRESS, INSERM, INRAE, Université Paris Cité, 75004, Paris, France.
Department of Odontology, Charles Foix Hospital, AP-HP, 94200, Ivry-Sur-Seine, France.
Eur J Pediatr. 2025 Mar 25;184(4):268. doi: 10.1007/s00431-025-06093-w.
The aim of this study was to investigate the relationships between the introduction of fruit juice or sugar-sweetened beverages (SSBs) before the age of 6 months and the presence of early childhood caries (ECC) at 3.5 years of age. The study is based on data from the population-based nationwide prospective cohort study ELFE (French Longitudinal Study of Children). Children were recruited at birth in 2011 in France. Detailed data on the children's diets, as well as socio-economic characteristics and dental caries at 3.5 years, were prospectively collected through online questionnaires and telephone interviews of the parents. The primary outcome was the presence of ECC reported by the parents at 3.5 years. The main exposure was the introduction of fruit juice or SSBs before the age of 6 months into the child's diet. Among the 10,921 children included, 1955 (19.5%) were exposed to fruit juice or SSBs before 6 months of age and 229 (3.0%) had ECC; 53 (4.7%) of exposed children and 176 (2.5%) of those not exposed had ECC at 3.5 years of age. Based on multivariable analysis, introduction of fruit juice or SSBs before 6 months of age was associated with ECC at 3.5 years (adjusted OR = 1.5, 95% CI [1.1, 2.2]).
This study indicates that early introduction of fruit juice or SBBs is associated with an increased risk of developing ECC, highlighting the need for early prevention by childhood professionals and nationwide prevention campaigns.
• Consumption of SSBs is a well-known risk factor for dental caries in children, yet fruit juices still culturally maintain a healthy image. • Limited data on ECC risk factors in children under 4 years have been published.
• The very early introduction of fruit juices or SSBs into a child's diet is later associated with ECC at 3.5 years. • This study is the first to investigate complementary feeding in relation to ECC before the age of 4 using a nationwide population-based design.
本研究的目的是调查6个月龄前引入果汁或含糖饮料（SSB）与3.5岁时幼儿龋齿（ECC）的存在之间的关系。该研究基于全国性基于人群的前瞻性队列研究ELFE（法国儿童纵向研究）的数据。2011年在法国，儿童在出生时被招募。通过在线问卷和对家长的电话访谈，前瞻性地收集了有关儿童饮食、社会经济特征以及3.5岁时龋齿情况的详细数据。主要结局是家长报告的3.5岁时ECC的存在情况。主要暴露因素是在6个月龄前将果汁或SSB引入儿童饮食。在纳入的10921名儿童中，1955名（19.5%）在6个月龄前接触过果汁或SSB，229名（3.0%）患有ECC；3.5岁时，53名（4.7%）暴露儿童和176名（2.5%）未暴露儿童患有ECC。基于多变量分析，6个月龄前引入果汁或SSB与3.5岁时的ECC相关（调整后的OR = 1.5，95%CI [1.1, 2.2]）。
本研究表明，过早引入果汁或SSB与患ECC的风险增加相关，凸显了儿童专业人员进行早期预防以及全国性预防运动的必要性。
• 饮用SSB是儿童龋齿的一个众所周知的风险因素，但果汁在文化上仍保持着健康的形象。• 关于4岁以下儿童ECC风险因素的数据有限。
• 儿童饮食中过早引入果汁或SSB与3.5岁时的ECC相关。• 本研究是首个使用全国性基于人群的设计调查4岁前与ECC相关的辅食喂养情况的研究。
